Technical Field.
The present invention relates generally to multi-port medical devices. More particularly, the invention relates to a medical manifold having rotatable ports.
Background Information.
During the course of a medical or surgical treatment, a patient may be incapable of adequately breathing on his/her own. In order to ensure that a sufficient supply of oxygen is provided to the patient, the physician may initiate a period of artificial ventilation. Artificial ventilation is typically carried out by inserting an endotracheal tube into the trachea of the patient via the mouth or nose, a process referred to as intubation. A mechanical ventilator supplies oxygen through the endotracheal tube (ETT) to the patient's lungs.
During management of such patients, it may be desirable to coaxially insert one or more catheters, etc., into the patient's trachea through the ETT. Such devices may be positioned to carry out a medical procedure, or as a diagnostic tool. Examples of medical procedures include placement of a balloon-tipped catheter (e.g., an endobronchial blocker) for lung isolation, as well as other procedures such as jet ventilation, etc. Examples of diagnostic procedures include monitoring of bodily temperature, pressure, gas composition, etc. In such cases, the distal end of the catheter typically extends beyond the distal end of the ETT, and in many instances, is inserted into either the right or left mainstem bronchus. To ensure adequate placement, the position of the catheter is generally viewed through the endotracheal tube with an elongated viewing instrument, such as a fiberoptic bronchoscope.
A multi-port manifold may be engaged with the proximal end of the ETT to allow for simultaneous placement through the ETT of a plurality of different medical devices. Examples of such devices include a catheter (such as the endobronchial blocker catheter described above), various diagnostic tools, a bronchoscope, and a wire guide. Additionally, the manifold provides a conduit for ventilation of the patient. In some manifolds, each of these features is carried out through a separate port.
A distal port of the manifold is connected to the ETT. Another port is generally positioned in-line with the distal port, and with the lumen of the ETT. When introducing a bronchoscope into the airway, the bronchoscope is inserted through the in-line port, and extended through the distal port to ensure suitable visualization into the trachea. In some applications, a wire guide is inserted through a working channel of the bronchoscope, and directed into the desired right or left mainstem bronchus under visualization through the bronchoscope.
Once the wire guide is positioned in the desired region, the bronchoscope is removed from the in-line port. The catheter (e.g., an endobronchial blocker) is inserted over the wire guide in the in-line port, and advanced in the direction of the desired mainstem bronchus. The bronchoscope is then inserted through a side (angled) port to visualize the advancement of the catheter, and to verify that the catheter has entered the proper mainstem bronchus. Difficulties may be encountered when advancing a bronchoscope through a side port. A bronchoscope is typically a delicate instrument which has the ability to be tip deflected from the proximal end. However, the tip deflecting ability of such instruments can be impaired if the proximal end of the scope is at an acute angle with respect to the distal tip. In addition, when the bronchoscope is inserted through an angled port, the optics are generally not as suitable when compared to entry and advancement through an in-line port. In addition to the bronchoscope, other delicate and/or fragile instruments may be subject to impairment or damage if inserted through an angled port.
It would be desirable to overcome the problems encountered in the art by providing a manifold having multiple entry ports, wherein such ports are rotatable such that more than one port can be selectively axially aligned with the lumen of the ETT. It would further be desirable to provide rotatable entry ports wherein each port is arranged on the manifold in a manner such that each said port maintains access to the target site, to allow simultaneous passage of a respective medical device through each of said ports.